Bringing him home

[Barlemo]

Hi I haven’t been on this site for a long time as my husband was settled in a care home when his needs and behaviour became too much for me to manage. He has now been there for three years, supported by CHC funding and up until March this year I visited regularly and all was well. As you are only too aware, visiting in these last terrible months has been minimal and impersonal to say the least. I am shocked to learn as of yesterday that his care home has been rated inadequate by CQC following a series of inspections in the summer. We relatives have been assured, by letter, from the group that own the home that they are working hard to address the shortcomings and have already made significant improvements.

Husband’s condition has obviously deteriorated in the last three years, and has taken quite a severe downturn in recent months. He is no longer mobile and has very little speech, none comprehensible. He is doubly incontinent and cannot do anything for himself at all. He isn’t the physically strong man he was when he went into care, and the aggression is all but gone so in that respect would be easier to manage I think. I feel we are nearing the end.

I would like to be able to bring him home. But where on earth do you start? I owe it to him to do my best for him.

 

[Kellyr]

Hi @Barlemo theres a story similar to yours in the 'carehome visits' thread and @canarygives a very good response. Hope this helps..

 

[Sarasa]

This is the thread that @Kellyr mentioned Care Home Visits. I would think long and hard about how you would cope if you did bring him home, and what help you would need.

 

[Barlemo]

Thanks Kellyr that’s very helpful.

 

[Barlemo]

Sorry I mean Sarasa x

 

[canary]

Yes, there are quite a few people wondering the same thing as you.

In addition to everything I said on that thread, in your case I am wondering why he is still eligible for CHC as it is reviewed annually and often gets withdrawn. This says to me that he still has challenging behaviour of some sort. He might be still aggressive (its amazing how much damage even a frail bed-ridden PWD can inflict - their grip is something else!), but I think it more likely that he is considered a high falls risk. When they lose their mobility, some are content to stay sitting, but some think they can still walk/stand, get up and immediately fall; and this can happen several times a day or night. In a care home there can be carers immediately on the spot to hoist him up again and a nurse to check for broken bones, but if he is at home, you will usually be on your own - as it doesnt usually happen at a convenient time when there are carers around.

So (assuming that he is indeed a high falls risk) - you will have be on high alert every single minute of the day and night and its when you are asleep, in the loo/shower or trying to cook dinner that its most likely to happen, because thats when he will become anxious that he doesnt know where you are and will try and come looking. You can get alarms to tell you when he attempting to stand, but this doesnt help when you are in the loo. In my experience, once you get there the fall has already happened. IMO the only time an alarm is usefull is at night to wake you when he falls. Once he has fallen you then have a problem. Do you try and lift him yourself and risk injuring him and yourself? Do you call the paramedics out so that they can lift him and check him over? Do you wait for the carers (might be several hours) and the district nurse to check him? If you keep calling out the paramedics they will send a report into Social Services, as may the care agency.

Think very long and hard before attempting to bring him home. I know you are upset about the CQC report (I would be too), but perhaps there may be another way to resolve this.

 

[Sarasa]

I think stories such as this one How We Sprang Grandma, make taking someone out of a care home sound easier than it usually actually is. There is also a narrative in some newspapers, I've noticed it in the Guardian for instance, that care at home is to be preferred to a care home. All this adds to the feelings of guilt we have because we can't see our loved ones, or if we can the visits are unsatisfactory due to covid regulations.
As to inspections. I don't know a lot about CQC inspections, but I happened to be in my mum's care home when one was taking place last year. The manager was doing a great job of ensuring the inspector saw what he wanted him to see. I was roped in, as pre-lockdown as well as visiting mum I helped out with some of the activities and he wanted the inspector to see that they had lots of engagement from relatives so there was a conversation about something I was going to be doing later, that involved him photocopying something that he thought would be of interest. The home got an 'outstanding' and it is very good, but not necessarily better than a home that just gets a good.
Have you seen the report? I might not know much about CQC, but having been involved in loads of OFSTED inspections in my career I know that sometimes something reactively minor can mark you down, and that some of the decisions are pretty subjective. I agree if there are causes for concern they need to be addressed, but if the company has plans in place, and you were previously happy with the care, I wouldn't let it concern you too much.

 

[Barlemo]

I think stories such as this one How We Sprang Grandma, make taking someone out of a care home sounds easier than it usually actually is. There is also a narrative in some newspapers, I've noticed it in the Guardian for instance, that care at home is to be preferred to a care home. All this adds to the feelings of guilt we have because we can't see our loved ones, or if we can the visits are unsatisfactory due to covid regulations.
As to inspections. I don't know a lot about CQC inspections, but I happened to be in my mum's care home when one was taking place last year. The manager was doing a great job of ensuring the inspector saw what he wanted him to see. I was roped in, as pre-lockdown as well as visiting mum I helped out with some of the activities and he wanted the inspector to see that they had lots of engagement from relatives so there was a conversation about something I was going to be doing later, that involved him photocopying something that he thought would be of interest. The home got an 'outstanding' and it is very good, but not necessarily better than a home that just gets a good.
Have you seen the report? I might not know much about CQC, but having been involved in loads of OFSTED inspections in my career I know that sometimes something reactively minor can mark you down, and that some of the decisions are pretty subjective. I agree if there are causes for concern they need to be addressed, but if the company has plans in place, and you were previously happy with the care, I wouldn't let it concern you too much.

I think stories such as this one How We Sprang Grandma, make taking someone out of a care home sounds easier than it usually actually is. There is also a narrative in some newspapers, I've noticed it in the Guardian for instance, that care at home is to be preferred to a care home. All this adds to the feelings of guilt we have because we can't see our loved ones, or if we can the visits are unsatisfactory due to covid regulations.
As to inspections. I don't know a lot about CQC inspections, but I happened to be in my mum's care home when one was taking place last year. The manager was doing a great job of ensuring the inspector saw what he wanted him to see. I was roped in, as pre-lockdown as well as visiting mum I helped out with some of the activities and he wanted the inspector to see that they had lots of engagement from relatives so there was a conversation about something I was going to be doing later, that involved him photocopying something that he thought would be of interest. The home got an 'outstanding' and it is very good, but not necessarily better than a home that just gets a good.
Have you seen the report? I might not know much about CQC, but having been involved in loads of OFSTED inspections in my career I know that sometimes something reactively minor can mark you down, and that some of the decisions are pretty subjective. I agree if there are causes for concern they need to be addressed, but if the company has plans in place, and you were previously happy with the care, I wouldn't let it concern you too much.

I think stories such as this one How We Sprang Grandma, make taking someone out of a care home sounds easier than it usually actually is. There is also a narrative in some newspapers, I've noticed it in the Guardian for instance, that care at home is to be preferred to a care home. All this adds to the feelings of guilt we have because we can't see our loved ones, or if we can the visits are unsatisfactory due to covid regulations.
As to inspections. I don't know a lot about CQC inspections, but I happened to be in my mum's care home when one was taking place last year. The manager was doing a great job of ensuring the inspector saw what he wanted him to see. I was roped in, as pre-lockdown as well as visiting mum I helped out with some of the activities and he wanted the inspector to see that they had lots of engagement from relatives so there was a conversation about something I was going to be doing later, that involved him photocopying something that he thought would be of interest. The home got an 'outstanding' and it is very good, but not necessarily better than a home that just gets a good.
Have you seen the report? I might not know much about CQC, but having been involved in loads of OFSTED inspections in my career I know that sometimes something reactively minor can mark you down, and that some of the decisions are pretty subjective. I agree if there are causes for concern they need to be addressed, but if the company has plans in place, and you were previously happy with the care, I wouldn't let it concern you too much.

Yes, there are quite a few people wondering the same thing as you.

In addition to everything I said on that thread, in your case I am wondering why he is still eligible for CHC as it is reviewed annually and often gets withdrawn. This says to me that he still has challenging behaviour of some sort. He might be still aggressive (its amazing how much damage even a frail bed-ridden PWD can inflict - their grip is something else!), but I think it more likely that he is considered a high falls risk. When they lose their mobility, some are content to stay sitting, but some think they can still walk/stand, get up and immediately fall; and this can happen several times a day or night. In a care home there can be carers immediately on the spot to hoist him up again and a nurse to check for broken bones, but if he is at home, you will usually be on your own - as it doesnt usually happen at a convenient time when there are carers around.

So (assuming that he is indeed a high falls risk) - you will have be on high alert every single minute of the day and night and its when you are asleep, in the loo/shower or trying to cook dinner that its most likely to happen, because thats when he will become anxious that he doesnt know where you are and will try and come looking. You can get alarms to tell you when he attempting to stand, but this doesnt help when you are in the loo. In my experience, once you get there the fall has already happened. IMO the only time an alarm is usefull is at night to wake you when he falls. Once he has fallen you then have a problem. Do you try and lift him yourself and risk injuring him and yourself? Do you call the paramedics out so that they can lift him and check him over? Do you wait for the carers (might be several hours) and the district nurse to check him? If you keep calling out the paramedics they will send a report into Social Services, as may the care agency.

Think very long and hard before attempting to bring him home. I know you are upset about the CQC report (I would be too), but perhaps there may be another way to resolve this.

 

[Barlemo]

Thank you all so much for your very sound advice. You’re right of course, there would be many, many potential problems and challenges, more than before I now realise. The ‘how we sprang grandma’ story is heartwarming and I wish her and her family well - but my husband is not so compliant in his care and, although somewhat frail compared to how he was, still resists strongly, and yes he does have a vice like grip. Also he’s in his early 70s, not his late 90s. I feel he is nearing the end, but it is impossible to know that, so the care could go on for years. In my fantasy I imagine that he would be so happy to be home he would rally and it would be all sweetness and light. But the reality probably wouldn’t be like that at all, and then what? Start all over again placing him in care? I don’t have the strength to go through all that again.
Thanks again for listening. It has helped a lot to talk it through with people who understand x

 

[lemonbalm]

I think stories such as this one How We Sprang Grandma, make taking someone out of a care home sounds easier than it usually actually is

Yes, they make it sound so frightfully jolly, like a bit of mischief and something we could all do if only we dare. Lots of smiling faces and everyone having a lovely time.

 

[Wishing20]

Thank you all so much for your very sound advice. You’re right of course, there would be many, many potential problems and challenges, more than before I now realise. The ‘how we sprang grandma’ story is heartwarming and I wish her and her family well - but my husband is not so compliant in his care and, although somewhat frail compared to how he was, still resists strongly, and yes he does have a vice like grip. Also he’s in his early 70s, not his late 90s. I feel he is nearing the end, but it is impossible to know that, so the care could go on for years. In my fantasy I imagine that he would be so happy to be home he would rally and it would be all sweetness and light. But the reality probably wouldn’t be like that at all, and then what? Start all over again placing him in care? I don’t have the strength to go through all that again.
Thanks again for listening. It has helped a lot to talk it through with people who understand x

I have seriously considered taking my Mum out of her Care Home, twice over. I’d arranged the appropriate care at home with a Care provider company. The first time I got very excited and thought it would be easy but then reality of what we were taking on made me change my mind. After further lockdowns I tried again, this time Social Services advised that Mum’s needs were met in the Care Home and if it wasn’t for visiting restrictions we wouldnt be considering this, which is absolutely true, so again, we stopped all the plans and she remains where she is. But every dat that goes by I so wish I could see her, be with her, hold her, hug her, take her for a walk. I miss her so much. She was a constant massive part of my families life, always involved in our lives and to know she is nearby but we just cant see her is the most terrible thing to bear. I just feel my poor Mum does not deserve this and cannot believe what is going on and wonder when will these restrictions ever end. My Dad feels like you, that fantasy that if Mum came home, it would be like the old days, but in the cold light of day, we do know that would not be that way. I feel your pain, deeply. We have just one consolation and that is that her needs are being met in terms of caring and we just hope she doesn’t miss us as much as we miss her

 

[jennifer1967]

i have worked in a care home when we had CQC inspections and theyve asked me questions. the home may well be doing the things needed but if the right words are not used or demonstrated, they will mark you down. we had improvements needed and were dealt with. sometimes its paperwork instead of interacting and caring for the residents. you can always ask if you have any concerns about the report

 

[Dutchman]

I’ve read the discussion on can I bring my love one home. Should I bring my love one home? I wanted so much to do this at the beginning because I missed her ( still do very much) and I nearly caved in especially when she kept making plans with me to escape. God it was so hard not to do it. She pleaded and got upset when i refused to listen.

Its a dream really that everything will go back to normal. All the good works by the staff would be lost, you’d certainly lose the room at the home
( they’re like gold dust) and if it all goes wrong
( likely) you’d have start again. Please think very carefully. I’m the worse one to take advice from as I’m always heartbroken missing my wife but I know I wouldn’t last long at home with her here as it was when she was at her dementia worse.

 

[Kellyr]

I think stories such as this one How We Sprang Grandma, make taking someone out of a care home sound easier than it usually actually is. There is also a narrative in some newspapers, I've noticed it in the Guardian for instance, that care at home is to be preferred to a care home. All this adds to the feelings of guilt we have because we can't see our loved ones, or if we can the visits are unsatisfactory due to covid regulations.
As to inspections. I don't know a lot about CQC inspections, but I happened to be in my mum's care home when one was taking place last year. The manager was doing a great job of ensuring the inspector saw what he wanted him to see. I was roped in, as pre-lockdown as well as visiting mum I helped out with some of the activities and he wanted the inspector to see that they had lots of engagement from relatives so there was a conversation about something I was going to be doing later, that involved him photocopying something that he thought would be of interest. The home got an 'outstanding' and it is very good, but not necessarily better than a home that just gets a good.
Have you seen the report? I might not know much about CQC, but having been involved in loads of OFSTED inspections in my career I know that sometimes something reactively minor can mark you down, and that some of the decisions are pretty subjective. I agree if there are causes for concern they need to be addressed, but if the company has plans in place, and you were previously happy with the care, I wouldn't let it concern you too much.

CQC is not fit for purpose. The carehomes pay a fee to join apparently so there is a definite conflict of interest. I had dealings with them myself and they were useless. A carer at my Mums home said if something gets reported, CQC ring up the home and tell the manager what was said instead of checking it out.. Shocking!

 

[jennifer1967]

CQC is not fit for purpose. The carehomes pay a fee to join apparently so there is a definite conflict of interest. I had dealings with them myself and they were useless. A carer at my Mums home said if something gets reported, CQC ring up the home and tell the manager what was said instead of checking it out.. Shocking!

they do gp surgeries as well who pay a fee depending on how many patients on their books. ofsted is the same education inspecting education and the police investigating their officers. dont think there is too much objectivity in any of it which has been demonstrated by enquires. i like this forum because it challenges me into learning about things if im not sure about

 

[nitram]

You can calculate the fees paid to CQC

Fees calculator | Care Quality Commission

Use our calculator to find out what fees you should pay.

www.cqc.org.uk

 

[jennifer1967]

You can calculate the fees paid to CQC

Fees calculator | Care Quality Commission

Use our calculator to find out what fees you should pay.

www.cqc.org.uk

i googled it and their scale of charges for different categories